Continuing with the medical Reddit thread series this episode is on second opinions that saved lives! Responding to Reddit ...

quotdoctors-of-redditquot-3-second-opinions

&quot;Doctors of Reddit&quot; #3: Second Opinions

this guy told me he had pinkeye he had metal shards in his eye from welding God can that happen hey guys dr. Mike here welcome to the third episode of responding to reddit threads this week's response video is gonna be to the thread titled doctors have read it what's your thank God they came in for a second opinion moment I know mine are you ready for me to tell you I'm working in urgent care and the last patients on my schedule happened to be part of a family and when I walk into the room they're covered in bruises they looked horrible I get in horrible condition it almost look like they belong in a level one trauma center I asked what happened they told me they were coming back from a road trip unfortunately they got into a car accident driving like 70 miles an hour they were treated let go but they were still having so many symptoms that they wanted to come see me my first question was give me your records show me what tests were done in this place where you were treated they give them to me I look and it's like okay scan one scan to scan three labs this that everything looks decent where's the scan of the head to make sure you're not bleeding inside your brain and you're like oh they told us we shouldn't do it that we didn't need it I'm thinking to myself that's crazy not only is one of the family members on blood thinning medication but they were involved in a 70 mile an hour car accident so despite the fact that was very difficult to get them to the ER for the second time that day I made it happen we got them there and what do you know they were scanned one of the family members bleeding into the brain ended up staying in the neuro ICU and is affected to this day had they gone home not seeing me went to sleep the outcomes would have been much worse so that's my thank God for a second opinion moment now it's time for me to read and react to yours well not yours but redditors are people in radical oh sorry my dad went to the same ear doctor for around nine years due to poor hearing and was told there was nothing wrong when he finally went to a second doctor they referred him to the hospital found tumors in his ears that had eaten entirely through his inner ear bones and eardrums he needed for operations to remove them one every six months if the second doctor hadn't offered their opinion he probably would have had tumors eaten to the back of his skull and to his brain well I don't know if that's true but the fact that you're going to see a doctor for nine years and you have a loss of hearing they're telling you everything's fine that's wrong you have a symptom if they're not curing the symptom or addressing the symptom we're explaining why the symptom is there they're not doing their job are you yawning during my reddit thread that's so rude you're a nurse here had a lady in for simple pneumonia her 13 year old son was getting bored so I showed him some equipment I connected a simple heart monitors to him and discovered he was in complete heart block I printed a strip and showed it to the doc we suddenly and unexpectedly cardiac patient yeah that's crazy that's like in medical school when we're all listening to each other's hearts practicing and then we find out someone has like a serious heart condition that's crazy I had a doctor in high school who was unconcerned when I suddenly developed vertical double vision which was freaking out everyone in their emergency room where I had gone initially and had lost 60 pounds for no reason that's an insane amount of weight loss it was only a year or two later when I told him that my arm would fall asleep much faster than normal when I raised to ask it a question in class that he thought there might be something wrong with me MRI ordered brain tumor found bare isn't that crazy bear doesn't sound concerned that's a crazy story to me because the first question you ask even if you're remotely concerned about a cancer history is do you have any weight loss unintended weight loss specifically and when they say yes that encourages me to start scanning and looking for things that I normally don't check for having a 60 pound weight loss should automatically be a red flag raising your hand and having it fall asleep on you not a huge red flag that could be simply an issue with cervical radiculopathy which means that like your vertebrae where the nerves come out in between your vertebrae can get impinged and cause symptoms that shoot down the nerve or cause it together for you to develop some numbness or tingling 60 pound weight loss that's major disease unless proven otherwise and I think bear agrees dermatologists here I have seen probably five instances if my other doctor told me he was fine there were melanomas a lot of times people don't want full of skin exams there are lots of perfectly sane reasons for this time perceived cost history of personal trauma however I routinely find cancers people don't know they have keep this in mind if you see a dermatologist for acne and they recommend you get an account yes there's so many patients of mine that I recommend that we do full skin exam or maybe even offer them a referral to the dermatologist and they pass up on it melanoma is one of those cancers that's growing in diagnosis and it's one that can be incredibly dangerous because it spreads when it metastasized it's really weird areas of the body like the eye bone like these are problems that you just want to avoid with careful screening psychiatrist here a thirty year old man with mild depressive symptoms was in and out of the hospital fairly quickly he was under pressure from his home life living with four roommates who were making life a bit difficult for him no suicidal thoughts he was cleared of all psychopathologies by me and two other doctors a few months later he came back same symptoms however this time he talked about five roommates it felt wrong and I dig him too his story tried to contact his roommates he lived alone and was severely psychotic I have no idea to this day how he hid it so well from everyone when we scanned for psychosis we look for inconsistencies between the patient's subjective experience of thinking being and acting and the objective reality accepted by the general cultural norm this patient managed to live in a subjective psychotic world that just fits so well with the objective reality that he tricked several psychiatrists including myself in this day and age it's very easy for that to happen we want to be as understanding and open and non-judgmental as possible however if you're trying to established whether a patient is basing their current situation in reality sometimes you have to ask probing questions but now there's an art to this you can ask questions by making yourself seem very curious as opposed to inquisitive as if like your detective that little change in tone can go a long way especially with the patient who may be psychotic or psychologically ill in an end an elderly gentleman was brought in by his concern adult children for chest pain he wanted to believe his primary doctor that it was just some gas or Harper but his son just had a gut feeling and made him go to the ER with everyone so you can get checked out heart attack was imminent like we weren't sure if treatment would take effect in time to prevent it declared code blue means heart stopped all hands on deck place went from the very quiet of the ER to sheer chaos in minutes there's no doubt in my mind that this gut feeling saved his life Wow knowing your own body and being a good advocate for yourself or having a family member that knows you well and is a good advocate for you is crucial in getting better health outcomes that's why those who don't have an extended family or are not married generally have worse health outcomes because they don't have someone to advocate on their behalf I got a moderate traumatic brain injury in October and the week after I got home from the hospital I wasn't acting like myself was refusing to eat and just didn't make much sense my mom called the doctor a few times they said it was normal but to take me in if anything changed she took me in on Saturday a week later because I started slurring my speech and was unsteady on my feet their injury caused my sodium levels to drop from 140 to 119 that's quite dangerous this in turn caused stroke like symptoms which were in reality a small series of seizures yeah electrolyte imbalances are no joke and sodium levels potassium levels calcium levels all need to be kept in homeostasis by your body's organs in order for you to stay alive any disorder that weather makes it those levels go up or down can have life or death consequences can you imagine potassium can kill makes you think about eating but nah just kidding you can eat bananas and nothing bad will happen because your own body's organs will decide how much potassium to take in how much to let out so on so forth I went to my family doctor the worst headache of my entire life she dismissed it telling me was a tension headache and I should take a Tylenol léna darkroom first of all when a patient says I'm the worst headache of my life you don't even think as a family medicine doctor you say are you certain of this you clarify quantify ask some questions you send them to the ER because the worst headache of my life that specific explanation was also known as the thunderclap headache is something that needs to be chapter the cat scan right now because we're looking for bleeding over the course of the next month I saw her a total 13 times each time with worsening symptoms first it was dizziness then vomiting then eventually I could no longer see out of my right eye every time she told me was a tension headache or a weird migraine gave me a prescription for painkillers and sent me on my way the final straw is when I could no longer walk properly I would try and take a step but all I could manage was this weird shuffle she reluctantly agreed to send me to a neurologist the next day I showed up in his office and was there for less than a minute he took one look in my eyes and immediately called an ambulance turns out on a hydrocephalus my ventricles were five times the size they were supposed to be and my brain was literally being squeezed out of my head figure hydrocephalus is really scary condition because that increases pressure and the ventricles which are the spaces within your brain actually start swelling from increased fluid and actually start pushing the brain and increasing pressure on it which can cause your brain to herniate out of the brainstem oh my god that's just an awful condition can result in death I'm an emergency medicine doc in the Midwest USA the patient was transferred from rural nowhere to our tertiary care facility big Hospital with every specialist call was of really bad quality but the transferring physician described a 21 year old male that had rapid heart rate and breathing rate low blood pressure low oxygen confusion and a severe opacification his chest x-ray on the right side diagnosed pneumonia he gave him a ton of fluid start antibiotics put him on a ventilator but he wasn't getting better and wanted to send him to us sure send away an hour later the gentleman arrives looks young fit and not the type to just drop dead from pneumonia we roll him onto our stretcher and find a huge stab wound in his back the x-ray finding was his entire right chest was full of blood we put a tube in it gave him some blood and he had to go for surgery to fix the bleeding lesson look at your patient this is why one of the biggest lessons that I learned working a level one trauma center as a medical student is the first thing you do in an emergency in a trauma situation inspect the entirety of the patient especially when a patient is unconscious because when they're unconscious they can't tell you the data was to have wound in their back but unless you check that you won't know why a patient is in shock experienced while doing residency in China kit came in via reference from his village doctor he had a few random episodes of seizures well guess what imaging at our hospital showed there were a few multiple larvae cysts in his head yep kid loved to go to the rivers and put frogs in his mouth he wouldn't eat them but he would just licked them don't ask me why not gonna lie I probably would not think about larvae and frog licking as part of my history taking here in New York City maybe there's more that I need to learn you got to check out my other two reddit episodes right here or if you want me to compare what it's like to be a real doctor verse TV doctor click here and I'll see you in one of these videos which ones are gonna be [Music] [Applause] [Music]

Dr.

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